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1104290295
AMY GREEN
LAFAYETTE, LA
NPI
1104290295
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: LA RN096295)
Enumeration Date
2015-11-30
Last Update Date
2015-11-30
Business Address
-- AMY GREEN
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508-6917
Phone number: 337-278-9159
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Mailing Address
-- AMY GREEN
PO BOX 375
CADE, LA 70519-0375
Phone number: 337-278-9159
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